Death rates at Bay Area hospitals vary widely, new report reveals

While some hospitals excelled at keeping patients alive, more than half of institutions around the Bay Area had worse-than-average death rates for at least one medical procedure or patient condition in 2010 and 2011, a new state report reveals.

Washington Hospital in Fremont had the dubious distinction of being among only a handful of hospitals statewide with worse-than-average death rates in several categories.

Others, however, topped their peers with better-than-average death rates in two or more areas, including Alta Bates Summit Medical Center in Oakland, Eden Medical Center in Castro Valley, John Muir Medical Center in Walnut Creek, and Kaiser Permanente in Redwood City.

When it comes to treatment, striking differences in death rates are revealed for such illnesses as heart failure, acute heart attacks, intestinal bleeding and strokes, depending on where a patient is treated.

The report released this week is part of a national movement toward more transparency in health care, to aid consumers and to encourage poor-performing hospitals to improve. The state released its first such analysis in 2006.

"We hope that consumers will use this as a guide to start conversations with their health care providers," said Merry Holliday-Hanson, manager of the administrative data program at the Office of Statewide Health Planning and Development, which prepared the report.

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Such statistics are one factor, but not the only thing to consider, in judging hospital quality, she said.

Researchers looked at mortality rates for 12 conditions and procedures at 331 California institutions. They adjusted the death rates to take into account such risk factors as a patient's age and other health problems, then identified which hospitals had rates significantly better or worse than state averages.

Washington Hospital had the largest number of worse-than-average rankings in the East and South Bay. In 2010, it fell below state averages in three categories: acute stroke, pneumonia and repair of a bulging abdominal aorta.

In 2011, it had worse-than-average death rates for heart failure and pneumonia patients.

"We constantly monitor and identify opportunities for improvement in all areas of patient care," Washington Hospital spokeswoman Gisela Hernandez said in a written statement.

"This report provides a starting point but ... the data should not be regarded as definitive measures of quality," she said, adding that it should be considered with other measures and trends.

Good Samaritan Hospital in San Jose has revised its policies for treating heart failure since 2010 and 2011, when it had worse-than-average death rates for such patients, said Dr. Arthur Douville, chief medical officer.

"We certainly value public reporting," he said. "Our job is to take this data and work hard to make our numbers look better by doing the best for patients."

In the last couple of years, Good Samaritan has had a care coordination team evaluate its heart failure patients daily to ensure they have proper testing and medications and an appropriate discharge plan, Douville said.

"With those kinds of measures, we're going to see improvements in patient outcomes," he predicted.

John Muir Medical Center was among a handful of hospitals with a mixed result. In addition to better-than-average rankings for brain surgery and intestinal bleeding, its Walnut Creek campus had worse-than-average death rates for acute stroke patients in 2011, and its Concord campus had a similar ranking for stroke patients in 2010.

Other hospitals often transfer patients with cerebral bleeding to John Muir because it can handle such cases, but that can skew death rates, said Dr. Raymond Stephens, director of John Muir's primary stroke program.

Stephens noted that the state report does not take into account families that don't want aggressive care if a loved one becomes paralyzed or has other severe injuries.

Kaiser in Redwood City also had mixed results, ranking better than average for two conditions in 2011 but worse than average for two in 2010.

O'Connor Hospital in San Jose had a 7.1 percent death rate for pneumonia patients in 2011, compared to a state average of 4.1 percent. The hospital follows national care guidelines, said spokeswoman Donna Cumming. She added: "We will continue with our internal monitoring and investigation of possible causes and implement corrective action to ensure patient safety."

The financially struggling St. Rose Hospital in Hayward had worse-than-average death rates for its acute heart attack patients in both 2010 and 2011. Hospital attorney Mike Sarrao said the safety-net hospital often sees sicker patients than other institutions because many low-income people lack preventive care. And because the hospital can install stents in blocked arteries, it tends to get more patients who need such care, he said.

But another financially struggling hospital that serves large numbers of low-income patients achieved better-than-average death rates for its acute heart attack patients in 2011. Doctors Medical Center in San Pablo had a death rate of 2.4 percent -- well below the state average of 6.5 percent.